A 68-year-old woman with no history of nasal disease presented with a 3-week history of a fluctuating right-sided frontotemporal headache, nausea, vomiting, photophobia, and drooping of the right eye and a 1-week history of right-sided diplopia. Physical examination revealed an oculomotor and abducens nerve palsy, a dilated pupil, diplopia, proptosis, ptosis, and decreased visual acuity in the right eye. The findings of the rest of the neurologic and general physical examinations were unremarkable.